HomeMy WebLinkAboutPermit Building 2006-08-08Plcrte lndlclt. rll other rtruchrros thrt now orlst
on the property:
_ Non3.
Hour/llobllc Honr
G.rrg.rshrd/Stong.
-Bm
lndu.Hd Bulldtng(rl
Comm.El.l Bldg
R.llglar Bulldlng
Publlc Bulldlng
Othar, pl.[a dcrcrlbt:
ltlhow wat!r .nd lrnlt.ry t.illc.s wlll
WATER
_ nono, not.ppllc.ble
_ wdl _ wtter dlrtrlcf
Dlctrlct Nrmr:
mry b. r.qulr.d prlor to bulldlne p.rnlt
SEPTIC INSTALLED
_Y.3 BPrSP*
PlaIa
'Proo, o, atvlca
lsmcr.
br provldrd.
slf
-NoValuation of proposed work:
Alrernative tr'inenei nl Scrrrriecs Inc
Owner of Property
240 Oak^zay Certer, Eugeee, Oegc,n
_Donald T.. Waler
contractor/lnstallezsu,ldii Nam--
Mrsl'faCEured Horr- Repl-aCemenf for Residenliel rrse
(54LL ss6-q524
Owner Address
(s4r) 556-9s24
Your Address
CCB Licen3€ #
ziq
ztq
(54t\ 556-9524
Phone
240 0a1c,vay Corter, Eugere, Oregon
Do-rald L. Waler
Your Name (The pgEg! signing this form)
Proposed work and use:
Fton;-
9740L
Phone
9740L
MAP/PARCEL NUMBER:
(Found on tax maps in the Assessment & Taxation Dept.)
tB 03 ll 22 02300r*.t',p R"r,€" Effi ffiffi;- ffii-
Appllcatlons made w/ln the last 30 days:
9740t
Plamlng ts, ril bo dctsrnlncd on thr conbnt ot lt{r lku.
Addreer
Clty/Sht Ap
Er:gerre, Or
Sife Address:
2031 \ierbor Drive, Springfield, Or 97477
Dlrsctions to slte from nearest maior intersection:
H:d:ra'r -l}-ira-
fho frain i-rael<sTalza (nrrJ-lr )nA ntrar
For Mobile Horne PlaamentOnly:
. PaIm i{arborErano:
MH is being built no licsrseffi-ruunber issued
Llcense # (No. always starts with X):
Distance in feet
from MH to: Water: _ Septic/Sewer: _
2007
Size (W&L):27-*.\2 No. of Bedrooms:j
x#
Year:
appllcable programs to
ap
alsoLane
the
ass6s8 fees as
) the forogoing statements and other information attached hereto
to the best of my knowledge and belief; 2) I have the following
_Lowner of record, _ contract purchaser, _lessee,
option to purchase, _duly authorized to act for a person who
interest:
of record is knowledgeable of this application if I am not
oo
Add
I hereby certify that:
owner
legal
and
S
Date:
are true
has the
Iec.
Revised 2,/05
Mall PermitTo:
Donald L. Waler
240 Oalc\^/ay Center
ac if )rnrrr gning rn Tlrrrric rAnr.h lnke
tlris
The
I,ANE COUNTY
RECEIPT
PERMIT #
POSTED oN: 08/27/2006
sPo67324
SUB_TYPE: AUTHSITE
Type
RECEIPT NUMBER:
TYPE:
SITE ADDRESS:
PARCEL:
APPLICANT:
Method
R06006114
Sanitation--Permit
2037 HARBOR DR SPR
18-03-11-22-02340
WALER DONALD
240 OAKWAY CENTER
EUGENE OR
97 40L
556-9524
Description
LCPWSGS
Amount
Pa1,'rnent Credit Crd VISA
Des cripti-on
535.10
Current Pymt
2000
2100
30 65
4 010
4100
10.00
59.40
29 .10
40.00
396.00
New Technology Eee
Admi-nistrati-ve Fee
Long Range Planning Surc
DEQ Surcharge
Sanitation-Permi-t Review
PAID BY: DONALD WALER
Mfu*foteG'
15 //ou)h)*,, a/,*a#6q
(
I
E
CUSTOMER'S ORDEB NO.
SOLO BY
RECEIVED BY
NVIRON
All claims and returned
(
IICES,l-e.
ol
L H
a6/"ru//
f1
@l 66
i:L
rui$t..dtittr1li*si*6.$.dititlit$1iiti$rfl (iiiit\trt&
36
3o?
biil.
THANK YOU
.l)iil
a:
PAID OUT
m@
MDSE. REID.CASH c.o.D.ACCT,
e
I vr'
l,/rsflP lzafl
r-T-I
":0.1q401I
Snrinsi re address 20i7 Harhor Prlive
TAX
TOTAL
.:.i. ,, ilirrrL!j:rirAMOUNT. ii:';ii.:
or
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